botulinetoxine

Botulinum toxin, or botulinetoxine, is a highly potent neurotoxic protein produced by Clostridium botulinum and related species. Eight serotypes (A–G) have been described; types A, B and E are most associated with human disease and with medical use. The toxin acts by blocking neurotransmitter release at the neuromuscular junction, leading to flaccid paralysis.

At the molecular level, botulinum toxin cleaves SNARE proteins required for vesicle fusion, thereby preventing acetylcholine release and causing paralysis of skeletal, autonomic, or smooth muscle.

It is used clinically to treat a range of conditions including cervical dystonia, blepharospasm, strabismus, spasticity, chronic migraine, overactive bladder, and severe axillary hyperhidrosis. It is also used for cosmetic reduction of facial wrinkles. Administration is by intramuscular injections, and for some indications by subcutaneous injections, with dosing tailored to toxin type, indication, and patient.

Safety considerations include potential local injection reactions, ptosis, dysphagia, and, with higher doses or spread beyond the injection site, generalized weakness. Contraindications include known hypersensitivity to the product and infection at the injection site; caution is advised in people with neuromuscular disorders such as myasthenia gravis. Dosing should be performed by trained professionals to minimize risk. The effect is temporary, typically lasting from two to twelve months depending on product, dose, and indication.

History and regulation: botulinum toxin was identified from botulism toxin in the late 19th century. Since the 1980s it has been developed for therapeutic and cosmetic use under regulated medical products. In many regions, products are marketed under brand names such as onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport), incobotulinumtoxinA (Xeomin), and others.